Pain perception in hip osteoarthritis

James Powell, Pamela Railton, Andrew Delaney

Research output: Book chapter/Published conference paperConference paper

Abstract

Purpose:
It is recognized that there is a poor correlation between the clinical presentation and the imaging of an arthritic hip, in patients with hip osteoarthritis. The aim of the study was to see if there are differences in sensory transmission from the periphery to the brain. Somatosensory evoked potential (SSEP) testing was done to verify that somatosensory information was relayed to the brain in all subjects with no disruption in the pathway to the brain.
Method:
Thirty patients (17 male and 13 female) mean age of 54.5(38-71) who were scheduled to have a total hip replacement and 10 controls (4 male and 6 females) with a mean age of 54 (38-61) were recruited for the study. Using a 0-10 visual analogue scale (VAS), patients were asked to grade their pain based on an average over the previous 4 weeks. Using this information patients were
divided into groups low pain (1-4) and high pain (6-9). SSEP testing was done by stimulating the posterior tibial nerve using surface electrodes. Recording electrodes were placed at standard SSEP tibial nerve configuration points. The voltage intensity was increased to elicit a muscle twitch in the great toe and
then decreased to a comfortable level. Stimulation currents, as well as absolute and relative latencies were analysed comparing low pain and high pain groups with controls.
Results:
There were no delays in latencies measured between the control and arthritic group. There was a statistically significant difference in the stimulation current between patients with low pain and high pain, but this could also be attributed to differences in the patients age and body mass index. There was a statistically significant difference between P31 and N34, the lumbar electrode and erb’s point (union C5-C6 nerve root) between patients with high pain vs low pain(p
Conclusion:
The results show that there are no differences in the latencies and the nerves are conducting at a normal speed. There is a statistically significant difference in the relative amplitudes in the patients in the high pain group. These relative amplitudes between the spinal cord and erb’s point and between the brainstem, thalamus and cortex suggest that there is a central sensitization process for
sensory information in osteoarthritis vs control.
Original languageEnglish
Title of host publicationPain perception in hip osteoarthritis
Place of PublicationVictoria, Canada
PublisherCanadian Orthopaedic Association
Edition2018
Publication statusPublished - 19 Jan 2018
Event2018 Canadian Orthopaedic Association Annual Meeting - Victorian Convention Centre, Victoria, Canada
Duration: 20 Jun 201823 Jun 2018
https://coa-aco.org/annual-meeting-2018/

Conference

Conference2018 Canadian Orthopaedic Association Annual Meeting
CountryCanada
CityVictoria
Period20/06/1823/06/18
Internet address

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